The autobiographical book Mad, Not Stupid is about Meezan Zahra Khwaja’s Bipolar Type-I (BP-I) journey in a conservative Pakistani society. In our country, mental health issues are usually not understood.
The book begins with how Meezan dealt with the illness the first time at the young age of seventeen, when she went into mania, the high of bipolar and thought that agents from CIA were following her and that her friend was a robot. There was a complete break with reality in her thoughts. She explains how difficult it was to cope with being BP-I, in Pakistan back in 2000. Her fellow students made fun of her, there was no awareness about the illness and there was a great deal of stigma surrounding mental illness. Meezan then goes on to explain how the illness has shaped her life: the manias (highs), the euthymias (normal periods) and the depressions (severe lows). Reading her simple and graceful narrative, one begins to understand what a bipolar patient’s life is like and how difficult it must be for such an individual to cope with life on a daily basis.
She explains that one should not fall prey to negative mentality or thinking of oneself as a victim, rather one should always remain positive, for there is hope. Although 60 to 80% of bipolar disorder cases may be genetic, but then so are so many other illnesses. Meezan highlights her solid bonds with family members and true friends throughout her life, the few people who have understood the illness and stood by her. She also appreciates that there is the flip side: the illness means she has mental capability, so she has been able to have a wonderful career chequered by her highs and lows. She admits that it is an achievement that she has been able to pass her undergraduate and even her Masters degree from abroad with this illness. Not only this, she founded and ran her own NGO, the Ali Faateh Foundation (AFF). Under the AFF’s Barkat Jan Primary Girls’ School, in the Walled City of Lahore, free education was provided to girls from underprivileged backgrounds for a decade.
Meezan recommends a combination of cognitive therapy and anti-psychotic medication and mood stabilisers to put one’s life on the right track. She even gives a list of tried and tested techniques that patients can use to make sure they maintain equilibrium – such as prayer, yoga, meditation using apps like Headspace or Calm, and avoiding their triggers eg music or unpleasant company. She introduces the reader to online bipolar platforms such as PatientsLikeMe, which can be joined for community interaction to help them feel less lonely.
The book goes on to explore the problems faced by the mental health sector in our country. For this, Meezan has extensively interviewed therapists and physiatrists to ascertain what is rotten in the state of mental health in Pakistan.
The first barrier to therapy is education. Pakistanis believe in myths and superstitions, or in ‘dum darood’ rather than medical science. Pakistanis also feel that they are wasting their money since they get no ‘product’ in return. In the government sector, doctors are seeing 30 to 40 patients each day, so they just can’t pay individual attention to their patients. Further, women who come to therapy are dependent on men and when therapists empower them their marital relationships often suffer in our patriarchal society. Older patients don’t come to therapy, which is yet another problem. What is needed is to cause awareness regarding mental health. According to Meezan, the government can help the cause of mental health by publishing books about mental health issues in Urdu and local languages so that society is made aware of these issues.
The psychiatrists that Meezan has interviewed say that the patients they see in the public sector, eg Services Hospital, Ganga Ram Hospital or Mayo Hospital, are the ones who cannot afford private fees. These patients often travel from far-off rural areas, or urban slums. They cannot afford fees of the doctors or the medication, so they turn to public health care. Though patients are often unhappy with public sector care which can be deficient due to lack of resources, one should imagine the chaotic situation that would emerge if the public sector did not exist. There is a big population that the public sector caters to. There are long queues in the public health sector, because the psychiatrists are less, and the patient load is more. Obviously, those individuals who can afford to visit private psychiatrists and therapists do so, and often get “better” care. Awareness is lacking everywhere, even in cities, where one can say information is more readily available.
The way society views mental health must change. Perhaps the older generation’s mindsets cannot be changed now, but we can surely work on informing the students and children of today so that the newer generation doesn’t grow up on age-old stereotypical views of the mentally ill passed down by their elders. It would be better that they learn new ideas from schools, conferences, books and TV, so that their minds open up to accept psychiatric patients as one of us.
Meezan very innocently describes how she came about with the title of the book from a visit to poet Munir Naizi’s house, who was her father’s friend. The poet turned around to her father and said “Main pagal aan, bawakoof tay naheen.” And Meezan says that made her realise that she might be mad but at least she’s not stupid. The end message of the book is one of kindness and empathy, reminding us that we must be kind to our fellow humans, family, friends and especially strangers. That is how the human race will flourish.
The book is brave because it is the first time any person suffering from mental health in Pakistan has publicly written about it in this form. It is simple in its writing style and contains poems that keep the narrative moving along. I consider Meezan to be a beacon in the darkness that is the mental health domain of Pakistan, trying to carry a torch that not many are helping her out with. I would recommend anyone interested in human progress to read it.
The book begins with how Meezan dealt with the illness the first time at the young age of seventeen, when she went into mania, the high of bipolar and thought that agents from CIA were following her and that her friend was a robot. There was a complete break with reality in her thoughts. She explains how difficult it was to cope with being BP-I, in Pakistan back in 2000. Her fellow students made fun of her, there was no awareness about the illness and there was a great deal of stigma surrounding mental illness. Meezan then goes on to explain how the illness has shaped her life: the manias (highs), the euthymias (normal periods) and the depressions (severe lows). Reading her simple and graceful narrative, one begins to understand what a bipolar patient’s life is like and how difficult it must be for such an individual to cope with life on a daily basis.
She explains that one should not fall prey to negative mentality or thinking of oneself as a victim, rather one should always remain positive, for there is hope. Although 60 to 80% of bipolar disorder cases may be genetic, but then so are so many other illnesses. Meezan highlights her solid bonds with family members and true friends throughout her life, the few people who have understood the illness and stood by her. She also appreciates that there is the flip side: the illness means she has mental capability, so she has been able to have a wonderful career chequered by her highs and lows. She admits that it is an achievement that she has been able to pass her undergraduate and even her Masters degree from abroad with this illness. Not only this, she founded and ran her own NGO, the Ali Faateh Foundation (AFF). Under the AFF’s Barkat Jan Primary Girls’ School, in the Walled City of Lahore, free education was provided to girls from underprivileged backgrounds for a decade.Meezan recommends a combination of cognitive therapy and anti-psychotic medication and mood stabilisers to put one’s life on the right track. She even gives a list of tried and tested techniques that patients can use to make sure they maintain equilibrium – such as prayer, yoga, meditation using apps like Headspace or Calm, and avoiding their triggers eg music or unpleasant company. She introduces the reader to online bipolar platforms such as PatientsLikeMe, which can be joined for community interaction to help them feel less lonely.
The book goes on to explore the problems faced by the mental health sector in our country. For this, Meezan has extensively interviewed therapists and physiatrists to ascertain what is rotten in the state of mental health in Pakistan.
The psychiatrists that Meezan has interviewed say that the patients they see in the public sector, eg Services Hospital, Ganga Ram Hospital or Mayo Hospital, are the ones who cannot afford private fees. These patients often travel from far-off rural areas, or urban slums
The first barrier to therapy is education. Pakistanis believe in myths and superstitions, or in ‘dum darood’ rather than medical science. Pakistanis also feel that they are wasting their money since they get no ‘product’ in return. In the government sector, doctors are seeing 30 to 40 patients each day, so they just can’t pay individual attention to their patients. Further, women who come to therapy are dependent on men and when therapists empower them their marital relationships often suffer in our patriarchal society. Older patients don’t come to therapy, which is yet another problem. What is needed is to cause awareness regarding mental health. According to Meezan, the government can help the cause of mental health by publishing books about mental health issues in Urdu and local languages so that society is made aware of these issues.
The psychiatrists that Meezan has interviewed say that the patients they see in the public sector, eg Services Hospital, Ganga Ram Hospital or Mayo Hospital, are the ones who cannot afford private fees. These patients often travel from far-off rural areas, or urban slums. They cannot afford fees of the doctors or the medication, so they turn to public health care. Though patients are often unhappy with public sector care which can be deficient due to lack of resources, one should imagine the chaotic situation that would emerge if the public sector did not exist. There is a big population that the public sector caters to. There are long queues in the public health sector, because the psychiatrists are less, and the patient load is more. Obviously, those individuals who can afford to visit private psychiatrists and therapists do so, and often get “better” care. Awareness is lacking everywhere, even in cities, where one can say information is more readily available.
The way society views mental health must change. Perhaps the older generation’s mindsets cannot be changed now, but we can surely work on informing the students and children of today so that the newer generation doesn’t grow up on age-old stereotypical views of the mentally ill passed down by their elders. It would be better that they learn new ideas from schools, conferences, books and TV, so that their minds open up to accept psychiatric patients as one of us.
Meezan very innocently describes how she came about with the title of the book from a visit to poet Munir Naizi’s house, who was her father’s friend. The poet turned around to her father and said “Main pagal aan, bawakoof tay naheen.” And Meezan says that made her realise that she might be mad but at least she’s not stupid. The end message of the book is one of kindness and empathy, reminding us that we must be kind to our fellow humans, family, friends and especially strangers. That is how the human race will flourish.
The book is brave because it is the first time any person suffering from mental health in Pakistan has publicly written about it in this form. It is simple in its writing style and contains poems that keep the narrative moving along. I consider Meezan to be a beacon in the darkness that is the mental health domain of Pakistan, trying to carry a torch that not many are helping her out with. I would recommend anyone interested in human progress to read it.